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Author: search.filters.author.Cavero-Redondo, Iván

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    Association between hyponatremia and mortality in neurocritical patients with traumatic brain injury: A systematic review and meta-analysis
    (Elsevier BV, 2026-05-27)
    Zornoza-González, Erika
    ;
    Saz-Lara, Alicia
    ;
    Cavero-Redondo, Iván
    ;
    ;
    Valladolid-Ayllón, Sara
    Introduction Traumatic brain injury (TBI) is a major global cause of death and disability. Hyponatremia is a frequent complication in neurocritical patients with TBI and has been associated with adverse clinical outcomes. However, the association between hyponatremia and mortality in patients with TBI remains uncertain and inconsistently reported. This systematic review and meta-analysis aimed to evaluate the association between hyponatremia and mortality compared with normonatremia in neurocritical patients with TBI and to estimate the incidence of mortality among patients with hyponatremia. Methods PubMed, Scopus, and Web of Science were systematically searched through February 2026, complemented by searches in the Cochrane Central Register of Controlled Trials (CENTRAL), Clinical Trials registers, and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). Observational studies evaluating the association between hyponatremia and mortality in adult patients with traumatic brain injury (TBI) were included. Pooled mortality proportions and pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using Der Simonian and Laird random-effects models. Subgroup analyses, sensitivity analyses, meta-regressions, and publication bias assessments were also performed. Results Eighteen studies were included in the systematic review and fourteen in the meta-analysis, comprising 6439 adult patients with traumatic brain injury. The overall mortality incidence among patients with hyponatremia was 11% (95% CI: 7–15%). Hyponatremia was not associated with increased mortality compared with normonatremia (RR: 1.06; 95% CI: 0.80–1.39). Subgroup analyses according to study design and timing of sodium assessment showed consistent findings without significant differences. Age, sex, and ICU length of stay did not significantly influence these associations. No significant publication bias was detected. Conclusion Hyponatremia was not associated with increased mortality compared with normonatremia. Early monitoring of serum sodium concentrations may be of clinical interest in neurocritical TBI care, although the prognostic significance of hyponatremia should be interpreted with caution given the heterogeneity and observational nature of the available evidence.
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    Circulating Lycopene and β-Carotene Levels Are Inversely Associated with Carotid Intima–Media Thickness: A Systematic Review and Meta-Analysis
    (MDPI AG, 2026-03-25)
    Cavero-Redondo, Iván
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    Saz-Lara, Alicia
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    ;
    Martínez-Cifuentes, Óscar
    ;
    Otero-Luis, Iris
    Background: Carotid intima-media thickness (IMT) is a well-established surrogate marker of subclinical atherosclerosis and a predictor of cardiovascular risk. Carotenoids, particularly lycopene and β-carotene, have been proposed as protective antioxidants against vascular damage, but evidence from population-based studies is inconsistent. Objective: We aim to perform a systematic review and meta-analysis of the associations between circulating levels of lycopene and β-carotene and carotid IMT in the general adult population, including potential sex-specific effects. Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science up to March 2025, following PRISMA guidelines (PROSPERO registration: CRD420251003810). Observational and experimental studies reporting cross-sectional associations between plasma carotenoids and IMT were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated via random effects models. Subgroup and meta-regression analyses explored potential modifiers, including sex and cardiovascular risk factors. Results: Thirteen studies (n = 9131; mean age 46.4–71.6 years) met the inclusion criteria, eight of which were eligible for meta-analysis. High circulating lycopene levels were significantly associated with low IMT (pooled OR = 0.70; 95% CI: 0.59–0.84; I2 = 65.7%). The association was stronger in men (OR = 0.62; 95% CI: 0.45–0.84) than in women (OR = 0.74; 95% CI: 0.58–0.95). In contrast, β-carotene was only marginally associated with IMT (pooled OR = 0.96; 95% CI: 0.92–0.99; I2 = 72.6%). Meta-regression suggested that systolic blood pressure modified the lycopene-IMT relationship, whereas body mass index and low-density lipoprotein cholesterol influenced the β-carotene-IMT association. No evidence of publication bias was found. Conclusions: Increased serum lycopene concentrations, and to a lesser extent β-carotene concentrations, are inversely associated with carotid IMT, suggesting a protective role of lycopene in vascular health. The effect appears more pronounced in men, highlighting potential sex-specific differences in carotenoid metabolism and cardiovascular risk modulation.
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    Association between homocysteine levels and arterial stiffness in the adult population: a systematic review and meta-analysis
    (Oxford University Press (OUP), 2026-01-22)
    Saz-Lara, Alicia
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    ;
    Lever-Megina, Carla Geovanna
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    Valladolid-Ayllón, Sara
    ;
    Tébar-García, David
    Purpose The aim was to evaluate the association between homocysteine levels and arterial stiffness in the adult population Methods Scopus, Web of Science, and PubMed databases were searched from their inception to November 30, 2024. The DerSimonian and Laird method was used to calculate pooled odds ratio (OR) estimates and 95% confidence intervals (95% CIs) of the associations between homocysteine levels (plasma and serum homocysteine) and arterial stiffness in the adult population. Results Finally, 17 studies were included in the systematic review, and 16 studies were included in the meta-analysis, and included a total of 31 049 subjects. Our findings provide evidence supporting the associations between plasma homocysteine levels and arterial stiffness (OR: 2.06; 95% CI: 1.50, 2.82) and between serum homocysteine levels and arterial stiffness (OR: 1.76; 95% CI: 1.17, 2.65) in the adult population. Conclusion For each μmol/L unit increase in homocysteine levels, the risk of arterial stiffness increased by 106% for plasma homocysteine and by 76% for serum homocysteine. These findings are of clinical importance for understanding the underlying mechanisms involved in vascular dysfunction to establish preventive strategies in the cardiovascular setting.